Identifiable Intangible Assets and Goodwill (Details 1) (USD $) In Thousands, unless otherwise specified	3 Months Ended	12 Months Ended
	Mar. 31, 2013	Dec. 31, 2012
Gross carrying amount of goodwill
Goodwill, Gross, Beginning Balance	$ 1,113,401	$ 1,098,706
Goodwill, Impaired, Accumulated Impairment Loss, Beginning Balance	(457,037)	(457,037)
Goodwill, Acquired During 2012	0	14,695
Goodwill, Impairment Loss During 2013	(220,800)	0
Goodwill, Gross, Ending Balance	1,113,401	1,113,401
Goodwill, Impaired, Accumulated Impairment Loss, Ending Balance	(677,837)	(457,037)
Home Health [Member]
Gross carrying amount of goodwill
Goodwill, Gross, Beginning Balance	272,389	267,058
Goodwill, Impaired, Accumulated Impairment Loss, Beginning Balance	(263,370)	(263,370)
Goodwill, Acquired During 2012	0	5,331
Goodwill, Impairment Loss During 2013	0	0
Goodwill, Gross, Ending Balance	272,389	272,389
Goodwill, Impaired, Accumulated Impairment Loss, Ending Balance	(263,370)	(263,370)
Hospice [Member]
Gross carrying amount of goodwill
Goodwill, Gross, Beginning Balance	841,012	831,648
Goodwill, Impaired, Accumulated Impairment Loss, Beginning Balance	(193,667)	(193,667)
Goodwill, Acquired During 2012	0	9,364
Goodwill, Impairment Loss During 2013	(220,800)	0
Goodwill, Gross, Ending Balance	841,012	841,012
Goodwill, Impaired, Accumulated Impairment Loss, Ending Balance	$ (414,467)	$ (193,667)